1

The Problem of Familiarity: A Contributor to the Transference/Countertransference Field

Mark Winborn, Ph.D.

Presented at the meeting of the I-RSJA

April 23, 2010, Boulder, Colorado

In this paper I attempt to outline the influence of "familiarity" on the progress of

analysis. The title could also be “the shadow of familiarity.” Familiarity generally refers to the

state of close acquaintance with something or someone. We encounter a sense of familiarity

constantly in our lives and our culture. The longing for familiarity is present in Dorothy‟s

lament in the Wizard of Oz, “There‟s no place like home”. We know a level of familiarity is

present when our patient says, “I knew you were going to say that.” Most of us are familiar with

the aphorism by Aesop -“familiarity breeds contempt” but William Bernbach was probably more

accurate when he said, “familiarity breeds apathy.” Certainly the experience of familiarity will

indeed be familiar to everyone in this room, but perhaps there will be a sense of looking at it

from a new perspective by the time we end. I‟ll offer several ways of conceptualizing the

experience of familiarity and some possibilities for engaging it more consciously.

In my discussion, I propose that familiarity is a particular aspect of the transference/

countertransference field which emerges over time and begins to shape and influence the

behaviors, perceptions, thoughts, and feelings of the participants. In discussing familiarity as an

aspect of the transference/countertransference field, I‟m using the term in its broadest sense,

meaning the full range of emotional and projective influences within the field, not just

unresolved neurotic complexes being projected into the field. I‟m also referring to it as an

influence that is co-created in the field rather than originating out of the individual psyche of

either the analyst or patient. While the sense of familiarity may exist unilaterally – the analyst

towards the patient, or the patient towards the analyst – I believe most often it is a mutually

constellated, bilateral experience.

2

I began to think about this subject sometime last summer and as I reflected on the subject

I realized I hadn‟t heard anyone discuss the issue, the issue hadn‟t been part of my analytic

training, nor did I recall seeing mention of it in the analytic literature. In my own practice, I was

noticing in a more explicit way, that certain cases felt somewhat stuck - that there was a sense of

predictability, comfortableness, or lack of anticipation with certain patients. In some of these

cases it also seemed to be accompanied by a shift toward a sort of friendly atmosphere in which

the use of first names created a slightly different feeling tone. As I began to attend to these

patterns, I also noticed a lack of movement psychologically, an absence of the mild anxiety or

heightened anticipation that so frequently accompanies deeper analytic work. In some cases it

began to feel like a stalemate position in chess in which each player continues to move but it

isn‟t possible for those moves to lead to a decisive conclusion of the game. While the

atmosphere didn‟t feel dead, it didn‟t have a feeling of being fully alive either. As Ogden (1995,

p. 695) has proposed, the sense of aliveness and deadness of the transference-countertransference

“may be the single most important measure of the moment-to-moment status of the analytic

process.”

In my thoughts, I began to wonder what it is about this feeling of familiarity that hinders

analytic process, why it occurs with certain patients and not with others, and whether there is

anything the analyst can do about it or with it. It strikes me as curious that the issue of

familiarity may come into play with someone who has only been seen for six or seven months

and yet not become problematic in an analysis lasting a decade or more.

It began to dawn on me that the experience of familiarity was one of being hidden in

plain sight. The issue of familiarity is so familiar that it operates as background to our various

foreground concerns in analytic work and therefore exists primarily as an implicit, rather than

3

explicit, experience in analysis. Familiarity is often found in the nuanced dance of the analytic

interaction: sessions following a similar pattern, opportunities for analytic focus that are

overlooked, or in the ritualized behaviors surrounding the analytic sessions - such as how we

start and end sessions or how we greet one another. In fact, I‟ve come to think of familiarity as

being like the Cheers Effect, “the place where everybody knows your name.” It is a kind of

pseudo-intimacy that provides a sense of being seen and known but without being seen or known

in a deeply relational way that characterizes the analytic experience.

Familiarity in the therapeutic setting is the most basic of experiences; an unconscious

given in the relationship. So comfortable, ordinary, or mundane that we forget to examine or

analyze our experience of it. At times it may also be something unseen that creeps in

insidiously, slowly impacting the intersubjective space and influencing our behaviors, attitudes,

and feelings about each other and what is occurring in that space. Familiarity is comfortable

because it requires so little of us as analysts. Resting in its seductive comfort we don‟t have to

wrestle with how to access what we don‟t know, to grapple with the frustrating limitations of our

technique, to feel abandoned by the dearth of images entering our reverie. When the feeling of

familiarity dominates the field, the tension of opposites, which we seek to hold in our work, has

been subtly lost, and yet because of the comfort of familiarity, it‟s often the case that the absence

of opposition is not noticed, just as Dorothy and her companions are not even aware of slipping

into a stupor amongst the poppies.

Interestingly, the feeling of familiarity in an analytic relationship can take on different

feeling tones. Sometimes a sense of familiarity can be very comfortable and feel rather related,

much like the glow of kinship libido (Jung, 1946, para. 431), although as Pizer (2004, p. 304)

points out “the sweetness of „kinship‟ between analyst and patient can be a silent killer of the

4

treatment process.” At other times, familiarity can feel dry, lifeless, or predictable. But I believe

that familiarity, even when it feels related, is actually not very related at all because, the effect of

familiarity is generally a subtle lack of engagement; a form of un-relatedness in which the

proximity to the otherness in the patient and the otherness in the analyst is lost. It results in a

diffusion of seeing rather than a sharpening of seeing, and a reduction in risk rather than an

increased likelihood of transformative risk-taking.

As it is conceptualized in this manner, I propose that familiarity is an aspect of the

ongoing analytic relationship which, in many instances, can interfere with or become an obstacle

or impasse in the unfolding of the analysis. For example, as the patient begins to care more

about the analyst as a person, one risk is that the patient may become less likely, rather than more

likely, over time to share their negative transference reactions with the analyst. Similarly, the

analyst, as time progresses, may be lulled or seduced into a feeling of knowing the patient, their

psyche, and their issues - eventually failing to see the emergence of new developments,

especially those emerging from the objective psyche. One way of thinking about familiarity is

that it promotes mutual blind spots. Both parties feel they know each other so there is a tendency

to stop looking for what they don‟t know.

I envision familiarity as a broader concept than impasse, but clearly connected to the idea

of impasse. Wolstein (1959, p. 135) nicely defines impasse as an area or dimension where the

two analytic participants are stuck resulting in the situation where “neither participant is capable

of free and independent movement.” More recently Atwood and Stolorow (1984) have described

impasse as the outcome of two subjectivities exerting unreflective reciprocal impact on each

other. An impasse may occur as a result of familiarity, but is not the only possible outcome of

familiarity. Formal impasses frequently arise around emerging material not yet understood or

5

around therapeutic errors not yet worked through. Pizer (2004, p. 292) makes this point

explicitly when he writes: “Impasse may lie in a trail of lost opportunities for reflection,” or as

Levenkron (2006, p. 157) indicates, impasse is often a result of the failure to negotiate

recognition. Because the influence of familiarity is more diffuse and less palpable than an overt

impasse, the need for intervention is often less noticeable. Mendelsohn (2007) suggests

cultivating “an expectancy, a preparedness for impasses, for breakdowns of mutual

accommodation that signal both disruption and opportunity.”

Ways to Conceptualize the Issue of Familiarity

At this point I‟d like to examine a few ways to conceptualize the experience of familiarity

more fully.

Otherness: As we become familiar we de-libidinze or de-cathect the “otherness” of the

object. From the analyst‟s perspective, when we begin an analysis, our desire to help or

understand is more abstract. Our libidinal energy at that point is more connected to the ethos of

our professional role rather than the person. As the analysis progresses, we invest more libido in

that person as an object who begins to sustain us as we sustain them. As this happens, as we

hold the patient in our psyche with a more personal form of attachment, we become more

sensitized to the person, anticipating how the patient will receive our interventions and

interpretations, often making it harder to move to an interpretive stance. Therefore, familiarity

can be thought of as a loss of connection to “otherness.”

When a case is new, it‟s fresh, exciting, unknown and full of possibility. It‟s easier,

during that initial phase, to listen for the multiple levels of meaning lurking between the words,

gestures, and sighs. As the case ages it becomes harder to listen with fresh ears, to engage our

6

imaginal reverie, or to feel the teleological urge towards new possibilities unless we find some

ways of recognizing and burrowing beneath the state of comfortable familiarity.

On some fundamental level, the unfamiliar isn‟t comfortable. One approach to the

problem that familiarity presents us is the idea of otherness – or more figuratively – the stranger.

William James (1984, p. 2), in discussing the role of philosophy, seems to adopt a similar

position: “Philosophy…sees the familiar as if it were strange, and the strange as if it were

familiar. It can take things up and lay them down again. Its mind is full of air that plays round

every subject. It rouses us from our native dogmatic slumber and breaks up our caked

prejudices.” I conceptualize the stranger as being different than the shadow, with the shadow

referring to what is unknown or unacceptable to the patient, while the stranger refers to what is

unknown to us about the patient and ourselves. The shadow is most often used as a one person

concept while “the stranger” lends itself to utilization as a two person concept because it can

include the experience of the other as well as considering “the stranger” as analytic third.

Jung primarily uses the term “other” to refer to the experience of otherness within

ourselves, usually in reference to the shadow or anima. In a similar fashion, Harding (1965) and

Redfearn (1994) both refer to all of the Self that is not ego, as the not-I. Therefore, Jung,

Harding, and Redfearn are all utilizing the idea of otherness primarily in terms of a one-person

psychology. If we‟re looking for the shadow and have already determined to that we must find

“the shadow,” we‟ve made the error of siphoning some, or much, of the strangeness away from

the emerging material. By attending to the quality of strangeness we better appreciate its

significance in the psychic system rather than simply naming it. Casement (2002, p. 111) says,

“When we are impatient to remove a sense of strangeness, and the unease of not knowing, we

sometimes settle for what is familiar.”

7

It‟s limiting and dangerous to only think of the other in intrapsychic terms, as a reflection

or function of shadow or anima, or to only see the outer other as a repository for our projections.

In doing so, we miss the opportunity to engage the inter-personal or inter-psychic other, i.e. the

other in the object. In thinking about otherness as only a reflection of shadow, there can be no I-

Thou experience because the otherness of the object is not considered. It is important, not only

to remember the stranger within ourselves and our patients, but to actually find ways to invite,

embrace, lure, or seduce the stranger back into the room, into the foreground of awareness and

engagement.

Role Responsiveness and Countertransference: Sandler‟s (1976) ideas about role

responsiveness in the analytic relationship provide another lens for looking at familiarity as an

issue in the transference/countertransference field. He proposes that in the analytic field each

participant is attempting to impose a role-relationship on the other. This includes the role they

attempt to create for themselves and the complimentary role they attempt to create for the other

at a particular time. He points out that these intra-psychic pressures are often only recognized

after they have been carried over into actions and indicates that it is often in the small departures

from analytic stance that these role-responsive interactions take place – in the small “extra-

analytic” comments, in the greeting, arrangements about practical matters, the telling of jokes,

etc. Sandler proposes that the extent to which the analyst becomes involved in this role-

responsiveness is actually a compromise-formation between his or her own tendencies and his or

her reflexive acceptance of the role which the patient is pushing for. In his own work, he often

finds clues about role-responsive enactments in the lacunae of patterns of behavior which aren‟t

analyzed with a particular patient, but which he realizes he would typically analyze with another

patient.

8

Similarly, Irwin Hirsh (2008) asserts that it is not unusual for analysts to 'coast' in their

countertransferences, and to not use their countertransference experience to help the treatment

progress towards analytic goals. He believes that it is quite common that analysts who have

some conscious awareness of a problematic countertransference reaction, or of a mutual

enactment, nevertheless do nothing to change that participation and to use their awareness to

move the therapy forward. Instead, analysts often prefer to maintain what has developed into

a mutually comfortable equilibrium in the treatment, possibly rationalizing that the patient is

not yet ready to deal with a potential disruption that an active use of countertransference

material might precipitate. By reinforcing the status quo in analysis, the outcome is often an

interminable analysis. Obviously, the ideas of Sandler and Hirsh have implications for the

experience of familiarity, either as a reflection of role responsiveness or in the tendency to

coast in the countertransference feeling of familiarity.

Unformulated Experience: The ideas of Donnel Stern (1983, 1989), who writes

articulately about what he terms unformulated experience, also provide a basis for understanding

familiarity in analysis. Stern (1989), operating from a constructivist perspective of

psychoanalysis, defines unformulated experience as any experience which has not yet been

reflected on and to which words have not yet been attached to give the experience explicit shape.

He hypothesizes that experience remains unformulated for reasons of comfort or security and

that disturbing possibilities of meaning are terminated before they reach the level of articulation.

The associated conscious experience is often vagueness, confusion, boredom, complacency, or a

lack of curiosity about the other. Stern‟s work on unformulated experience and Sandler‟s work

on role responsiveness have a degree of overlap because they both are attempts to address

material that operates in the lacunae of our awareness. These experiences are pre-logical,

9

meaning operating on the edge of awareness, and take form first in illogical thoughts, hunches,

intuitions, and subliminal perceptions. Because unformulated experience exists at a level too

vague to represent or imply conventional meaning the experience becomes constructed as it is

reflected upon and words are attached to it.

In Stern‟s model, unconscious material is not repressed but rather unformulated, and for

our purposes, a sense of familiarity would also be considered unformulated. Because it is

generally unexamined, the goal would be to become aware of this unspoken, unnoticed

background experience and begin to bring it up for reflection and discussion. Until the analyst

and patient discover these meetings and create a formulation of these relational states, the analyst

and patient are caught in the grip of the unformulated field. In addressing unformulated

experience, the primary objective is not selecting the correct interpretation, it is to make sense

that there is something there, previously unknown, to interpret, in this instance, the experience of

familiarity and how it is impacting the analysis.

Another important feature of Stern‟s work is his discussion of surprise as the primary

way in which we can become aware of unformulated experience. Stern (1989, p. 8) indicates

that “we are most likely to be surprised, to learn something new, if we pay attention to

experience which has little organization.” This is a somewhat different orientation than our

Jungian perspective which often focuses on trying to identify archetypal themes and complex

patterns in the patient‟s material. From Stern‟s perspective (1983, p. 76), we are least likely to

become aware of unformulated experience by attending in this focused manner. In fact, Stern

goes further and states that focused attention can be a defensive maneuver on the part of the

analyst or analysand as a means to keep the awareness of other material from emerging – (16) a

type of selective attention that excludes new awareness. The analyst‟s task is to create sufficient

10

“imaginative space” (Stern 1989, p. 22) in the analysis to think and act with freedom from his

own previous perceptions of himself and the patient – to emerge from embeddedness in the

perceptions of the moment and the past. Certainly, this must have been what Bion (1967) was

articulating when he said, “We must approach every session without memory or desire.”

Undoubtedly, Bion was talking about a stance or attitude to take towards the patient‟s material

rather than a literal forgetting of the patient. Ultimately, I suspect Bion was actually talking

about finding ways in which the analyst could see past familiar experiences and perceptions of

their patient and see the unfamiliar that also exists within each patient. However, the experience

of the familiar does have a purpose, because it is only possible to recognize the fresh encounter,

the new perception against the backdrop of the familiar. For Stern, the familiar becomes the

ground against which the figure of the unknown and new is cast.

Case Example 1: Recently I was with a long-term female patient when we began to make

new connections between present experiences and a history of abuse that is primarily associated

with her father. I noticed for the first time a pattern in her speech in which she kept references to

her father largely separated from references to the abuse – that is, she generally referred to the

abuse in a generic sense without referring to father. I realized I hadn‟t noticed this pattern before

even though this pattern of speech has gone on throughout her analysis. I offered an

interpretation that her tendency to block her father out of her thoughts in this way had also kept

me in a state of unknowing, disrupting my recognition that she was maintaining a split between

her father and her abuse. This was a new experience for me with her, i.e. the recognition of the

impact of her splitting and dissociative defenses on my psychological process. The next session

the patient came in and announced that she felt something significant had shifted during the

previous session. She indicated that the observation I made about keeping her father separated

11

from "the abuse" opened up an awareness in her and she emphatically stated, "it's a new

ballgame now." The patient said she was somewhat uncomfortable with the idea that blocking

out the connection in her own thoughts could also result in the blocking out of the connection in

my thoughts, because it made her think of her family and how they seem to block out the

knowledge of her abuse. She then reported a dream in which I'm sitting in front of her waiting

for a new chair to be delivered. There is a platform that is in place to hold the chair. In the

dream I appear very excited about the arrival of the chair. The chair locks into a slot in the

platform. In discussing the dream I brought up the possibility that either she or I were holding

me in an elevated position. However, this interpretation didn't feel accurate to her. She said she

was focused on the solidness of the platform under the chair - that it seemed to provide a secure,

stable position for the chair. In summary, I‟m not sure I would have noticed the contrast in the

way she spoke about her father and the abuse, or the impact of that on my internal process, if I

hadn‟t been thinking about the contrast between the familiar and the unfamiliar in this patient.

Defense Against the Unknown: The experience of familiarity in analysis can also be seen

as a defense against the unknown or the emergent. Sometimes it seems that the goal of

familiarity is simply to keep the unfamiliar out because one of the most frightening experiences

is when the familiar becomes the unknown. This disquieting shift is vividly depicted in the

movie “The Shining” when the familiar father, played by Jack Nicolson, transforms into the

feared unknown. According to Casement (2002, p. 111, 113) “we tend to limit our openness to

what is not known by obscuring this with whatever seems familiar…the urge then is to limit this

sense of strangeness, to make the unfamiliar seem more familiar. Sometimes, however, the

result (for the analyst) is an illusion of familiarity, and of pseudo-understanding, that may give

the analyst a sense of security but may not give the patient a sense of being understood.” In his

12

article “The Other” (2002), Stephen Frosh asks the question (p. 393) “What is it about otherness

that is so threatening to everyone…?” He attempts to answer this question by stating that

psychoanalysis has caused a great “decentering” in Western thought “whereby the subject is no

longer capable of being taken as the source and repository of psychic life. This decentering has

the name of the unconscious which reveals with great intensity the alien core inside each one of

us.” In extending this idea he quotes (p. 394) Julia Kristeva who says: “….[The] uncanny

foreignness is within us, we are our own foreigners.”

Like Stern (1989), Frosh sees danger in a hope of mastery or a movement towards cure

because he sees both as a retreat from recognition of the essential alienness of human

subjectivity. Frosh suggests that transformation results from constantly seeking the recognition

of the other, both within oneself and the object. It is this seeking out of otherness that maintains

“subjecthood because it brings the internal other to life and holds out hope that something can

done with it, name it and give it shape (p. 404).”

Frosh‟s (2002) work has some areas of convergence with Agnel‟s (1999) Jungian work

on “the familiar stranger.” Agnel (p. 293) focuses on the idea of analyst as stranger to the patient

and postulates that the polarities of the “strange” and “familiar” opposites play an active role in

the transference relationship. In Agnel‟s conception, the stranger, like Hermes, is the bringer of

the new, unexpected, unlearned, and unrecognized – all of which usher in the possibility of

change. From Agnel‟s perspective, it is often the values of the shadow that are split off when the

pole of familiarity is actively constellated. In this conceptualization of the transference-

countertransference field, it is the analyst who has the potential to act as a vehicle for the

transition to the strange pole by acting as a stranger, but a stranger on whom it is also possible to

project the contents of the familiar pole. Papadopoulos (2002, p. 165) adopts a similar position

13

by positing that we can only move towards wholeness with the other by keeping its otherness in

mind. Otherwise we don‟t experience the oppositionality or complimentarity necessary for

incorporation. He reminds us (p. 166) that identity is closely connected with the definition of the

other because a person understands his or her identity, at least partially, in relation to what he or

she is not. This is in keeping with Jung (1951, CW9ii, para 301) who states, “Where there is no

„other‟, or it does not yet exist, all possibility of consciousness ceases.”

Romantic Love: Another perspective through which to view the issue of familiarity is the

image of romantic love. Stephen Mitchell (1997, 2002), writing on the subject of love,

challenges the culturally held viewpoint that passionate romantic love can‟t be sustained over

time. His position is that romantic love, perhaps like the analytic relationship, is a frightening

proposition and that there is a greater fear associated with being known by another person on

whom one depends than being unknown by someone new, because someone new is

unconsciously felt to be replaceable. Mitchell (2002, p. 49) says, “Love, by its very nature is not

secure; we keep wanting to make it so.” He goes on, stating that we unconsciously attempt to

attain safety in romantic love by entering into a Faustian bargain in which we exchange passion

for security and that the sense of safety created by the familiar is not a given but an illusory,

collusive construction. We recoil from the danger posed by the importance one gives, implicitly

and explicitly, to the person we create this experience with. If the other person remains distinctly

other, they live psychologically outside our control, placing us in a psychologically precarious

position. Therefore, couples, both romantic and analytic, create multiple forms of enactment

which result in stale, habitual, lifeless forms of relatedness that offer the illusion of security

while undermining love and deeper connection. Goldner (2004, p. 395), in her commentary on

Mitchell‟s essay, reminds us that boredom and deadness are co-created – manufactured “by

14

collusive, unconscious design.” According to Mitchell (1997, p. 40), “Authentic romance cannot

arise where there is a willed, contrived separation between safety and desire” – safety and desire

must be in continual dialogue for authentic romance to exist and to continue.

We might look at the implications of Mitchell‟s thoughts for the analytic relationship.

Perhaps the experience of familiarity in the analytic relationship is partially a result of our efforts

to provide object constancy, to provide a safe holding environment, or to be the good therapist.

Levenkron (2006, p. 170) makes this point in writing: “It is not by establishing relatedness that

we open up communication; it is the opening up of communication that establishes

relatedness…as part of the trajectory of relatedness, confrontation plays an important role in the

coming into awareness of previously dissociated content…confrontations make people work, not

because they are threatening but because they touch on biases that have prevented us from

making use of new perspectives.” Perhaps we inadvertently create an environment that is too

safe, too familiar, too predictable for authentic connection to emerge. Our fears about hurting

the patient‟s feelings can often serve to keep us quiet and as Danielle Quinodoz (2006, p. 342)

points out, “one needs to be helped to be bold enough to become aware of the very existence of

one‟s own thoughts before the issue of daring to express them even arises.” By being too careful

to avoid upsetting, shaming, or otherwise hurting our patients, we create a relationship largely

devoid of the danger of encountering the otherness of one another. Levenkron (2006, p. 157)

speaks to this tendency saying: “Amid efforts to remain good objects, we often ignore signals

that dictate a more forthright and meaningful communication,” and Levenson (1989, p. 549) also

points out that "real affect always must imply an authentic risk."

Addressing the sense of familiarity is a challenge to the patient‟s expectation or fantasy

that analysis is supposed to be a comfortable, helping kind of relationship with a gentle,

15

benevolent guide. While sometimes an understandable expectation, it is also an expectation that

limits the range of possible interactions in an analytic relationship. Although there is a need for a

degree of trust, safety, and comfort in analytic work, there is also the possibility of becoming too

comfortable with each other and in doing so perhaps restricting the things we say to each other or

overlook things we might notice if we were less familiar.

Perhaps we need to focus more on being a constantly present object, available for use by

the patient in a variety of different ways, rather than always striving towards an ideal of object

constancy. Agnel (1999, p. 297) echoes this idea as follows: “…it is vital for the analysand to be

able to sense and recognize both warmth and coldness, closeness and distance, „maternal‟ and

„paternal‟ in the analyst. These are the circumstances necessary for him to „use‟ the analyst, as

Winnicott so rightly says, according to the whims of his intuition and his immediate inner

needs.” Similarly, Mendelsohn (2007) speaks of the dialectic of safety and risk and indicates

that the degree to which an analysis can be experienced “as a setting of safety, danger, caution,

risk taking, containment, or instability is a function of the participation, often …the unwitting

and unattended participation, of both members of the dyad.” In his discussion he draws an

important “distinction between experience that merely reinforces old hurts and that which

manages to be disturbingly familiar, yet different enough to be a basis for change.” Addressing

similar processes, Casement (2002, p. 121) talks about the “pain of contrast,” while Bollas

(1989, p. 211) utilizes the phrase “the dialectics of difference.”

Case Example 2: One patient, whom I‟ve seen for about eleven years, has always

referred to me as Dr. Winborn. However, during the past year he began to talk about feeling that

we would be friends if there wasn‟t a therapeutic relationship. Then he had several dreams in

which he experienced me in the role of a friend. About this same time there were a couple of

16

instances where he called me by my first name, first in a phone message and later in session. In

exploring that change in behavior he said it felt like it reflected a shift in our relationship.

Around the time these shifts were occurring I noticed that the patient‟s choice of session focus

shifted to a more surface level, outwardly oriented content and a decrease in focus on his inner

life. Interestingly, after several months, references to me by my first name dropped off

completely and our work returned to a deeper level of exploration. At this time my thoughts

about familiarity were still very nascent so I didn‟t offer any interpretation about the last shift.

However, I suspect that the patient was implicitly uncomfortable with the shift in the work that

happened as he felt closer to me in a familiarly friendly way and that he unconsciously curtailed

the first name references to maintain a sense of depth in the work.

The Compliant Container: Another perspective by which to understand aspects of

familiarity in analysis is the idea of a compliant container as proposed by Vera Lomanno-Adamo

(2006). Lomanno-Adamo, working with Bion‟s model of the container and the contained,

proposes a particular type of defensive structure in which only that which is pleasant and won‟t

cause conflict or pain is allowed to exist. Through an interactional dynamic “of ideal

accommodation, a compliant container makes any disagreements, contradictions, limits and

differences disappear, recognizing only what is very familiar and commonplace (p. 369).” This

dynamic between container and contained is marked by exaggerated accommodation of the

contained, by an excessive reasonableness, and an unrealistic harmony of connection. Often the

compliant container relates to those analytic processes by a misleading level of gentleness and

mildness. On the surface the analysis seems to be going well, without significant disruptions in

the transference-countertransference field. However, upon looking deeper the patient has not

been shaken up or strongly impacted by the analytic process.

17

Typically, in Lomanno-Adamo‟s experience, when fleeting disruptions do occur, there is

a collusion to avoid examining them in terms of the transference and there is a quick return to a

“deceptive state of gentle accommodation” (p. 371). Patients working within a compliant

container field typically bring in sufficient content to make it appear they are working, but find

ways to distance from the emotional and sensory experiences of that material, creating a falsely

reflective discourse. In the patient‟s compliant receptivity to communication from the analyst,

the content of the analyst‟s interpretations is eviscerated or ignored and only the pre- and para-

verbal aspects of the analytic relationship are recognized or absorbed, e.g. the tone of voice,

comfort of the couch, expression on the analyst‟s face, or the warmth of the room. It seems that

one of the primary functions of the compliant container is to maintain idealized identifications

and to maintain the analyst‟s status as a representation of the self rather than an emerging

representation of the object. The basic movement between integration and disintegration, which

is fundamental to transformation and creation, is missing in the compliant container field because

these basic movements primarily occur when emotional conflict emerges.

Case Example 3: In one case that I‟ve seen a little over a year, the patient presented in

the midst of an affair and contemplating a divorce. Relatively quickly there emerged a

predictability to our sessions. Over time it began to feel as if nothing was happening. There was

no significant discomfort, other than the discomfort for me of sameness. Each week he would

come in and tell me what was happening at work, what was happening in the progress of his

rather amicable and unemotional divorce process, and a little about the interactions with his two

young daughters. However, the content of his verbalizations seemed devoid of meaning or even

unconscious derivative communications. Following his report he would wait for me to take

direction of the sessions by asking him questions. It wasn‟t as though he was flat in his

18

responses. He would respond in an appropriately engaged manner but questions rarely resulted

in his initiation of a new thread or the sharing an additional thought or feeling after responding to

the question. He would simply fall back into a state of apparent waiting, content to respond but

never initiating. A few times I asked him about whether he felt he was benefitting from our

sessions, to which he would respond in a very earnest manner, “Oh yes, our sessions are very

beneficial to me,” but with little, if any, elaboration on how he experienced that benefit. In the

sessions, I saw little benefit in terms of a deepening connection to his inner life, changes in

perspective or behavior regarding his outer life, or evidence that he was able to utilize my

interpretations or observations to form any lasting internalizations.

Recently, I realized that he had recreated with me the type of relationship he has with his

wife, family members, friends, and in his career – an interpersonal stance that feels safe for him.

He creates a certain expectation in which the other person feels compelled to lead the interaction

so that he can then react. In doing this he maintains a feeling of safety by consciously and

unconsciously screening what he reveals about himself. I pointed out this pattern to him in our

sessions and in his extra-analytic relationships, especially with his wife. He agreed that he finds

it more comfortable to react rather than initiate and that he‟s always been concerned about what

people think about him. I offered that he might think about whether our sessions could be a

place where it‟s safe enough to experiment with doing something other than reacting. Initially,

he responded by saying, “maybe I‟ll make a list of topics between sessions to talk about.” I

replied, “What I‟m referring to is discovering those elements of yourself you might want to share

but which it feels safer to leave alone unless someone else discovers them for you.”

19

Conclusion

It can be difficult to approach the feeling of the familiar in the analytic field. In a

poignant scene from Lord of the Rings, Sam Gamgee stops suddenly in the middle of a cornfield

with a look of dread on his face which prompts Frodo to ask him what‟s wrong. Sam replies: “If

I take one more step, it'll be the farthest away from home I've ever been.” Clearly, Sam is

experiencing the fear associated with leaving the familiar behind. In many cases, the familiar

feels warm, comfortable, predictable, or safe. These are difficult feelings for the analyst to

relinquish, even in the service of greater analytic depth, and the patient may also be reluctant to

examine the experience of familiarity too closely, perhaps fearing a venturing into riskier psychic

territory. The patient may also hear our attempts at exploring the feelings of familiarity as an

indication they aren‟t doing therapy correctly, feeling criticized in the process of the exploration.

I‟m not advocating the adoption of a stance of formality as a means of avoiding a sense

of familiarity, nor am I advocating any attempt to avoid the feeling of familiarity in the analytic

setting. I think the danger for analytic work is not the feeling of familiarity itself but the lack of

sufficient consideration for how it impacts our various analytic relationships. Obviously, it is not

possible to defend against or diminish the influence of the familiar on an analysis, but by

considering the variety of ways it can influence an analysis, we can become more conscious of

this phenomenon. My aim is to bring the feeling of familiarity, as an emergent aspect of the

transference/countertransference field for many analytic relationships, to the foreground for

awareness and consideration. As with many aspects of analysis, the deeper we go the more

subtle and nuanced the phenomena we encounter. The work is in sorting through the experience,

reflecting upon it, and hopefully being able to articulate something in the field that allows the

unknown to emerge. I‟ll leave you with a statement from Patrick Casement (2002, p. 125) who

20

says, “if we really engage with something previously unknown to us we are changed by it. This

is because we are challenged by it. We are challenged in how we view ourselves, in how we

view the patient, in how we view our theory and our technique. If we resist the challenge we

may miss the significance of whatever threatens our present thinking.”

21

References

Agnel, A. (1999). “The familiar stranger.” J. of Analytical Psychology, Vol. 44, pp. 293-308.

Atwood, G.E. & Stolorow, R.D. (1984). Structures of Subjectivity: Explorations in

psychoanalytic phenomenology. Hillsdale, NJ: The Analytic Press.

Bion, W. (1967). “Notes on memory and desire.” The Psychoanalytic Forum. Vol 2, #3, pp. 271-

280.

Bollas, C. (1989). Forces of Destiny. Northvale, NJ: Aronson.

Casement, P. (1985/1990/1991). Learning from the Patient. New York: Guilford.

Casement, P. (2002). Learning from Our Mistakes. New York: Guilford.

Frosh, S. (2002). “The other.” American Imago. Vol. 59, pp. 389-407.

Goldner, V. (2004). “Attachment and eros: Oppossed or synergistic?” Psychoanalytic Dialogues.

Vol. 14, pp. 381-396.

Harding, E. (1965). The I and the Not-I. Princeton, NJ: Princeton Univ. Press.

James, W. (1984). The Essential Writings. Albany, NY: SUNY.

Jung, C.G. (1946). The Practice of Psychotherapy. CW16.

Levenson, E. (1989), “Whatever happened to the cat? Interpersonal perspectives on the self.”

Contemp. Psychoanal. Vol. 25, pp. 537-553.

Levenkron, H. (2006). “Love (and hate) with the proper stranger: Affective honesty and

enactment. Psychoanalytic Inquiry. Vol. 26, pp. 157-181.

Lomanno-Adamo, V. (2006). “Aspects of a compliant container.” Int. J. of Psychoanalysis.

Vol. 87, pp. 369-382.

Mendelsohn, E. (2007). “Analytic love: Possibilities and limitations.” Psychoanalytic Inquiry.

Vol. 27, pp. 219-245.

Mitchell, S. (1997). “Psychoanalysis and the Degradation of Romance.” Psychoanalytic

Dialogues. Vol. 7, pp. 23 -42.

22

Mitchell, S. (2002). Can Love Last?: The Fate of Romance Over Time. New York:

W.W. Norton.

Ogden, T. (1995). “Analysing forms of aliveness and deadness of the transference-

countertransference.” Int. J. of Psychoanalysis. Vol. 76: pp. 695-709.

Papadopoulos, R. (2002). “The other other.” J. of Analytical Psychology, Vol. 47, pp. 163-188.

Pizer, S. (2004). “Impasse recollected in tranquility love, dissociation, and discipline in the

analytic process.” Psychoanalytic Dialogues. Vol. 14, pp. 289-311.

Quinodoz, D. et. al. (2006). "Being a psychoanalyst: An everyday audacity." Int. J. of

Psychoanalysis. Vol. 87, pp. 329-347.

Redfearn, J.W. T. (1994). “Introducing subpersonality theory: A clarification of the theory of

object relations and of complexes with special reference to the I/Not-I gateway.” J. of

Analytical Psychology, Vol. 39, pp. 283-309.

Sandler, J. (1976). “Countertransference and role-responsiveness.” Int. J. of Psychoanalysis.

Vol 3, pp. 43-47.

Stern, D.B. (1983). “Unformulated experience.” Contemp. Psychoanal. Vol. 19, pp. 71-79.

Stern, D.B. (1989). “The analyst‟s unformulated experience of the patient.” Contemp.

Psychoanal. Vol. 25, pp. 1 – 33.

Winnicott, D. (1971) Playing and Reality. London: Routledge.

Wolstein, B. (1959). Countertransference. New York: Grune & Stratton.